HomeMy WebLinkAboutBuilding Permit Application a
ALL APPLICABLE INF 'MUST BP COMPLETED FOR APPLICATL{ON TO BE ACCEPTED
Date: ... . � /; �� Permit Number:
P. RECSAVE
Bluilding Peri-mit:.Application MARI 5 2016
Planning and Developmen t Services
Bbildiny and Code Regulation Division Lucucie ieiITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. LC,dunty, FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial.-,.. . Residential
PERMIT APPLICATION FOR: To Select from dropb x, click arrow at the end of line
Address: a A., ~ -t C1
Legal Description:Z%1Ar' kfT—.k ►Ay i l'QA- i
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Property Tax ID#: ��CI 1-S30 —Owl —600 —1 Lot No.
Site Plan Name: d G, Block No.
Project Name: . ;
Setbacks Front Back. Right Side: J Left Side:
wVng o UA i 40kn on-Ar ►�\5 �c, n\�-4w� rx �rov�c� �, c��\ -on S.w Q,�-Si& v+- rl er�o
Additional work to brejerformOd under t +s permit-check all nappy:
'HVAC as Tank ❑Gas Piping Shutters a Windows/Doors
Electric L_=1 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction_ .. $ of First Floor:
Cost of Construction:$ O� 0� Utilities.",Ft. wer Septic Building Height:
Name 4wF e-s\,-`rx uoOC ;Name: o
Address: �qy� �G+�� � , , 'Company: . t At . C.A S+.,. V►rn
City: L0a1a,\fA)A State: Address: kQ>A W vk-v-,
Zip Code ( L Fax: :City: Qac�S'►'- ���- state: •
Phone Nc ;Zip Code: �V\%4 Fax:��-u 1.�o1.Ob1
E-Mail:Gb.,um bIar,\,n�,Coh 'Picone No. -11-L- 111-01`1 CiH
Fill in fee simple Title Holder on nein page(if different 'E-Mail's +�ccaur +IN'����+
from the Owner listed above) ':State or County License:
; .
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: (Name:
Address: 'Address:
City: State: City: State:
Zip: Phone: ip: Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable 1116NDING COMPANY: _Not Applicable
Name: !Name:
Address: Address:
City: City:
Zip: Phone: tip: Phone:
i
I certify that no work or installation has commenced prior to the is�uance of a permit.
St.Lucie County makes no representation that its granting a permit ill authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes a d St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or attorney before
commenciog work.or0drding your Notice of Commencement.,-/ 'r r
S at o Owner/Ag nt/Lessee Sig` ture o Contractor License Holder _
STATE OF FLORIDA STATE OF FLORIDA /
COUNTY OF. �Cr �-. COUNTY OF ::5
The forgoing instrurnen as aclyiowledged befo a me The forgoing instrum was cknowledged before me
this day of 1�Pi 20 this frday of l2 20�&by
(Name of person acknowledging) Toame of person acknowledging)
at of Notary (Signature o ZNotaublic-St Florida IESLI.D ZELAYA ;a c: L n ELAYA
Personally Known _ Ft f'rn�'r �pn���a Personally Kn PFriduce���eFi�icaon .
NIY. MTSS�CJIV �.. € MY COMMISSION#�I`iG`'T72
Type of Identificatio 'Pco red, Type of Identification P o Q
y9�or ride. EXPIRES October 1,20 8
COmm1S$IOn NO. j407)398.0163 Fforl ryServlce,com _•, Commission No. 407 39e dts3Flor WJ ryservlce.com
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR .PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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